| Entity Name: | WK MEDICAL CENTER CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 May 2017 (8 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 01 Sep 2017 (7 years ago) |
| Document Number: | P17000042325 |
| FEI/EIN Number | 82-1510458 |
| Address: | 13304 SW 128TH STREET, MIAMI, FL, 33186, US |
| Mail Address: | 13304 SW 128TH STREET, MIAMI, FL, 33186, US |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003338138 | 2017-07-11 | 2024-03-19 | 13304 SW 128TH ST, MIAMI, FL, 331865899, US | 13304 SW 128TH ST, MIAMI, FL, 331865899, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 786-227-6498 |
| Fax | 3055702604 |
| Fax | 3053634412 |
Authorized person
| Name | EDEL QUINTERO |
| Role | PRESIDENT |
| Phone | 3054249060 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | AHCA |
| Number | HCC11075 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| QUINTERO SEGURA EDEL J | Agent | 13304 SW 128TH STREET, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| QUINTERO SEGURA EDEL J | President | 13304 SW 128TH STREET, MIAMI, FL, 33186 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000053246 | NEW FAMILY MEDICAL GROUP | ACTIVE | 2021-04-19 | 2026-12-31 | No data | 13304 SW 128TH STREET, MIAMI, FL, 33186 |
| G19000127813 | HMC MEDICAL GROUP | EXPIRED | 2019-12-03 | 2024-12-31 | No data | 12039 SW 132RD CT, UNIT 31, MIAMI, FL, 33186 |
| G17000074480 | SCAPE HEALTH | EXPIRED | 2017-07-11 | 2022-12-31 | No data | 13304 SW 128TH STREET, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-10-14 | QUINTERO SEGURA, EDEL J | No data |
| AMENDMENT | 2017-09-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-03-24 |
| ANNUAL REPORT | 2022-04-05 |
| AMENDED ANNUAL REPORT | 2021-10-14 |
| ANNUAL REPORT | 2021-02-12 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-06-14 |
| ANNUAL REPORT | 2018-04-30 |
| Amendment | 2017-09-01 |
| Domestic Profit | 2017-05-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
